I have written blog entries on muscle cramping, but it suddenly occurred to me that I have never touched on side stitches. This likely crossed my mind because I was dealing with one that came on in the middle of a workout one day. But is there any correlation between side stitches and performance nutrition techniques?.....well, lets find out....
What is a side stitch?
Some athletes call it a stitch - some call it a cramp. It's that pesky, cramp-like pain that is localized usually on the side, just below the ribs. Sometimes it is accompanied by stabbing shoulder joint pain. The level of pain varies from mild to severe. Sometimes athletes can exercise through the pain, while at other times this is simply impossible and pace must be slowed down or stopped completely.
What causes side stitches?
There are and have been many interesting theories throughout the years. The most recent theory is that the pain you feel is caused by the two layers of the peritoneum of your abdominal cavity brushing against each other, either due to a distended stomach or a loss of the lubricating fluid present between the layers. Factors that may increase your risk of side stitches include poor fitness level, inadequate warm-up time, or exercising at a high intensity (particularly if you haven't trained prior to do so).
What role does nutrition play?
Eating or drinking too close to the start of a workout may increase the risk of side stitches by causing a too-full stomach that pushes up against the layers of the peritoneum. On the opposite end, not drinking enough before a workout may also increase your risk by causing dehydration, which decreases the amount of fluid present between the layers of the peritoneum.
How do I avoid side stitches using performance nutrition?
Tip #1: If you are prone to side stitches, re-evaluate your pre-workout fueling regimen. If you eat right before you train, push back that snack to 45-60 minutes before and see if that makes a difference. If you eat 1-2 hrs before already, try adjusting what the snack consists of. It should be mainly carbohydrate (such as grains or fruits) with only a small amount of fat and protein. Try a banana with a small amount of almond butter, a half of a peanut butter and jelly sandwich, or maybe an English muffin with a small amount of butter.
Tip #2: Look at your pre-workout hydration techniques. A good rule of thumb is to hydrate throughout the day prior to the workout, then drink ~2 cups 2 hrs before the workout and ~1 cup 1 hour before the workout. If you train first thing in the morning, drink 2 cups of water as soon as your alarm goes off. Training early is not excuse to not drink fluids beforehand.
Tip #3: When hydrating during a workout, realize that water and sports drinks empty from the stomach much more quickly than soft drinks, energy drinks or juices. Also, cold fluids (vs. warm) and larger amounts of fluid empty more quickly (think gulping not sipping). However, avoid drink very large amounts of fluid at one time; instead drink about 4-5 gulps (4-5 ounces) at frequent intervals throughout the workout.